Helping Your Patients Find Nayzilam: A Practical Guide for Providers

As a healthcare provider who prescribes Nayzilam (Midazolam nasal spray) for seizure clusters, you've likely fielded calls from patients who can't fill their prescriptions. The combination of single-source manufacturing, specialty pharmacy distribution, and controlled substance regulations creates a perfect storm of access challenges.

This guide provides actionable strategies your practice can implement to help patients maintain continuous access to their seizure rescue medication.

Understanding the Access Problem

Nayzilam faces several unique access barriers that differentiate it from most prescribed medications:

• No generic competition: UCB Pharma is the sole manufacturer, with no FDA-approved generic Midazolam nasal spray
• Limited retail stocking: Many retail pharmacies don't routinely stock Nayzilam due to low volume and controlled substance inventory requirements
• Prior authorization prevalence: Most commercial and government payers require PA, adding days to weeks to the dispensing timeline
• High cash price: At approximately $884 per prescription without insurance, cost can be a significant barrier for uninsured and underinsured patients

For a deeper analysis of shortage factors, see Nayzilam shortage: what providers need to know.

Strategy 1: Leverage Pharmacy Finder Tools

MedFinder for Providers enables your staff to quickly search for pharmacies that currently have Nayzilam in stock. This eliminates the time-consuming process of calling pharmacies individually and can be integrated into your practice's prescription workflow.

Implementation tip: Train your medical assistants or prescription coordinators to check MedFinder before sending Nayzilam prescriptions to the patient's default pharmacy. If stock is confirmed at a specific location, route the e-prescription directly there.

Strategy 2: Establish Specialty Pharmacy Relationships

Specialty pharmacies are significantly more likely to stock Nayzilam consistently. Building relationships with one or two reliable specialty pharmacies can streamline access for your patient panel.

Steps to implement:

1. Identify 2-3 specialty pharmacies in your area that regularly stock Nayzilam
2. Verify they accept your patients' major insurance plans
3. Establish an e-prescribing connection
4. Create a reference list for your front desk and nursing staff
5. Confirm whether they offer home delivery for patients who cannot travel easily

Strategy 3: Proactive Prior Authorization

Prior authorization is one of the most common access barriers for Nayzilam. Proactive PA management can prevent gaps in therapy.

Best practices:

• Submit PA requests at the time of prescribing, not after the patient arrives at the pharmacy
• Maintain template documentation supporting medical necessity for Nayzilam (e.g., seizure cluster frequency, failure of or contraindication to rectal Diazepam, patient preference for intranasal route)
• Track PA expiration dates and initiate renewals 30 days in advance
• Appeal denials promptly with supporting clinical documentation

Strategy 4: Prescribe Backup Rescue Medications

During periods of supply uncertainty, prescribing a backup rescue medication alongside Nayzilam protects patients from going without coverage entirely.

Recommended approach:

• Prescribe Nayzilam as the primary rescue therapy
• Add Valtoco (Diazepam nasal spray) or generic Diastat (Diazepam rectal gel) as a secondary option
• Provide clear written instructions on when and how to use each
• Document the clinical rationale in the chart for insurance purposes

For patient-facing alternative information, share: Alternatives to Nayzilam.

Strategy 5: Connect Patients with Financial Resources

Cost barriers compound availability issues. Ensure your practice is aware of available financial assistance:

• UCB Nayzilam Savings Card: Eligible commercially insured patients may pay as little as $0 per prescription. Details at nayzilam.com/savings. Not valid for government insurance.
• UCBCares: UCB's patient support program can assist with insurance navigation and may provide medication for qualifying uninsured patients
• NeedyMeds and RxAssist: Third-party databases of patient assistance programs

For a comprehensive cost-reduction guide, direct patients to: How to save money on Nayzilam. Providers can also review: Provider's guide to helping patients save on Nayzilam.

Strategy 6: Educate Your Team

Every staff member who touches the prescription process should understand the unique challenges of Nayzilam access:

• Front desk staff: Know how to direct patients who call about access issues
• Medical assistants: Know how to check MedFinder and initiate PA requests
• Nurses: Know how to educate patients on proper use, storage, and when to call 911
• Physicians/APPs: Stay current on shortage status and alternative therapies

Strategy 7: Create a Patient Action Plan Template

Develop a standardized seizure rescue action plan that includes:

1. Primary rescue medication (Nayzilam) with dosing instructions
2. Backup rescue medication with dosing instructions
3. When to administer a second dose
4. When to call 911
5. Pharmacy contact information for both primary and backup medications
6. Insurance and financial assistance resources

Providing this at each visit empowers patients and caregivers while reducing after-hours calls to your practice.

Resources for Your Practice

• MedFinder for Providers — Find Nayzilam in stock
• Nayzilam shortage: provider update
• Nayzilam drug interactions
• What is Nayzilam: complete guide